Follow-up of women with gestational diabetes in the Tehran Lipid and Glucose Study (TLGS): a population-based cohort study.

AIM

Women with gestational diabetes (GDM) are at increased risk of developing type 2 diabetes mellitus (T2DM), but there is disagreement regarding this conversion rate or its cardiovascular consequences. We investigated the metabolic and cardiovascular consequences of women with GDM in a population-based cohort study.

MATERIAL AND METHODS

Three groups of women were selected from the Tehran Lipid and Glucose Study (TLGS) and followed up for an average 9 years: women with prior history of GDM (n = 29); women with history of macrosomia or stillbirth without GDM (MC-ST) (n = 570), and age- and BMI-matched controls (n = 628). The incidence of T2DM, hypertension (HTN) and dyslipidemia were compared between these groups. Statistical significance was set at P < 0.05.

RESULTS

During the 9-year follow-up, T2DM was diagnosed in 27.3% of women with GDM in comparison to 9.5% among the control group (P < 0/001); 7.4% of the MC-ST group versus 8.9% of control group developed T2DM during the study follow-up (P = 0/03). There was no significant difference in the incidence of HTN or dyslipidemia between these groups (P > 0/05).

CONCLUSION

Women with a history of GDM are at higher risk for developing T2DM later in life. The timely recognition of GDM may provide a 'teachable moment' during which women could be motivated to implement lifestyle modifications to reduce their T2DM risk.